Provider cost of treating oral potentially malignant disorders and oral cancer in Malaysian public hospitals

Raman, Sivaraj; Shafie, Asrul Akmal; Abraham, Mannil Thomas; Shim, Chen Kiong; Maling, Thaddius Herman; Rajendran, Senthilmani; Cheong, Sok Ching

doi:10.1371/journal.pone.0251760

Cited by 5 publications

(10 citation statements)

References 28 publications

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“…Performing timely diagnosis, administering appropriate therapies, and establishing regular maintenance protocols are essential for treating periodontal disease through neutropenic phases and preventing excessive oral bacterial development resulting from radiation-related changes in the head and neck. The critical nature of these therapies is supported by the finding of this study that the highest average annual expenditure for periodontal treatment occurred 1 year after diagnosis for patients aged 40-59 years and 2 years after diagnosis for those aged > 80 years [11,32].…”

Section: Discussionmentioning

confidence: 71%

“…Depending on the cancer stage and the patient's condition, oromaxillofacial cancer management often requires a combination of therapies such as multimodal treatment incorporating radiation and chemotherapy. The development of new diagnostic, pharmacological, and treatment technologies and the longterm care of cancer patients contribute to an increased dental treatment expenditure [11]. In addition, late treatment results in the high cost of oromaxillofacial cancer treatment in Taiwan.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to primary treatments, patients with oromaxillofacial cancer may require extra care and prior treatments to reduce treatment side effects, such as oral pain from the tumor or oral mucositis, weight loss, fatigue, nausea, vomiting, and altered salivary gland function. At all stages, multimodal treatment consistently resulted in higher expenditures than monotherapies [11,25]. Moreover, Meropol et al reported that the use of cancer therapeutics is dominated by supportive therapy agents (i.e., hematopoietic growth factors and antiemetics), and anticancer medication is the most expensive among medications administered in outpatient clinics [30].…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, some patients in stages I and II required primary excisions and general reconstructive procedures, which are relatively less costly [31]. Treating stage III and IV malignancies were more expensive than treating early-stage tumors, resulting in higher overall spending across the management period [11]. Detection of oromaxillofacial cancer early, cancer prevention, screening of high-risk patients, and early treatment are the most effective methods to reduce costs, limit treatment duration, and improve survival [1,31].…”

Section: Discussionmentioning

confidence: 99%

“…Cancer represents a high economic burden for patients, health sectors, and communities [11]. In 2010, the annual economic expenditure for cancer was estimated at US $1.16 trillion based on a total global gross domestic product of >2% [12].…”

Section: Introductionmentioning

confidence: 99%

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Outpatient Dental Treatment Expenditure for Patients with Oromaxillofacial Cancer: A Cohort Study in Taiwan

Ikbal

Shen

Liang

et al. 2022

IJERPH

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The information on the outpatient expenditure of patients with oromaxillofacial cancer is minimal. This study aimed to compare the average annual expenditure on dental treatment for these patients 5 years before and 5 years after oromaxillofacial cancer diagnosis. In this study, 7731 patients who received oromaxillofacial cancer diagnosis in 2005 were selected from the Registry of Catastrophic Illness Database as the case-cohort. In the control cohort, 38,655 people without cancer were selected from the National Health Insurance Research Database, with the case–control ratio being 1:5. All participants were observed for 5 years before diagnosis and 5 years after diagnosis. The conditional logistic regression model was used to determine the odds ratios of annual expenditures incurred by participants in the case-cohort. The measurement results indicated that in the oromaxillofacial cancer cohort, the average annual dental expenditure levels at 1, 2, 3, 4, and 5 years after diagnosis were US $97.34, US $77.23, US $109.65, US $128.43, and US $128.03 and those at these years before diagnosis were US $37.52, US $32.10, US $31.86, US $29.14, and US $29.35, respectively. In conclusion, the average annual expenditure on the dental treatment of oromaxillofacial cancer patients after five years of diagnosis was increased compared to five years before diagnosis.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Outpatient Dental Treatment Expenditure for Patients with Oromaxillofacial Cancer: A Cohort Study in Taiwan

Ikbal

Shen

Liang

et al. 2022

IJERPH

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Financial burden of heart failure in Malaysia: A perspective from the public healthcare system

Ong

Low

2023

PLoS ONE

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Background Estimating and evaluating the economic burden of HF and its impact on the public healthcare system is necessary for devising improved treatment plans in the future. The present study aimed to determine the economic impact of HF on the public healthcare system. Method The annual cost of HF per patient was estimated using unweighted average and inverse probability weighting (IPW). Unweight average estimated the annual cost by considering all observed cases regardless of the availability of all the cost data, while IPW calculated the cost by weighting against inverse probability. The economic burden of HF was estimated for different HF phenotypes and age categories at the population level from the public healthcare system perspective. Results The mean (standard deviation) annual costs per patient calculated using unweighted average and IPW were USD 5,123 (USD 3,262) and USD 5,217 (USD 3,317), respectively. The cost of HF estimated using two different approaches did not differ significantly (p = 0.865). The estimated cost burden of HF in Malaysia was USD 481.9 million (range: USD 31.7 million– 1,213.2 million) per year, which accounts for 1.05% (range: 0.07%–2.66%) of total health expenditure in 2021. The cost of managing patients with heart failure with reduced ejection fraction (HFrEF) accounted for 61.1% of the total financial burden of HF in Malaysia. The annual cost burden increased from USD 2.8 million for patients aged 20–29 to USD 142.1 million for those aged 60–69. The cost of managing HF in patients aged 50–79 years contributed 74.1% of the total financial burden of HF in Malaysia. Conclusion A large portion of the financial burden of HF in Malaysia is driven by inpatient costs and HFrEF patients. Long-term survival of HF patients leads to an increase in the prevalence of HF, inevitably increasing the financial burden of HF.

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Household Catastrophic Health Expenditure from Oral Potentially Malignant Disorders and Oral Cancer in Public Healthcare of Malaysia

Raman

Shafie²,

Abraham³

et al. 2022

Asian Pac J Cancer Prev

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Objective: Oral cancer causes a significant disease burden and financial distress, especially among disadvantaged groups. While Malaysia has achieved universal health coverage via its highly subsidized public healthcare, patient and family expenditure for treatment of oral potentially malignant disorders (OPMD) and oral cancer remains a concern in the equitability of care. This study thus aims to estimate household out-of-pocket (OOP) expenditures and the extent of catastrophic healthcare expenditure (CHE) while identifying its predictors. Methods: This three-part study consists of a cross-sectional survey to collect sociodemographic and health utilization data of patients, a retrospective medical record abstraction to identify resources consumed, and cost modeling to simulate expenditures in two tertiary public hospitals. Loss of productivity was calculated based on absenteeism related to disease management in the hospital. OOP payments for transport, care in public healthcare facilities, and other healthcare expenditures were tallied. A CHE was defined as OOP spendings of more than 10% from total annual household income. Multivariable logistic regression was further applied to identify the association between sociodemographic factors and the incidence of CHE. Results: A total of 52 patients with OPMD and 52 with oral cancer were surveyed and medical records were abstracted. A Kruskal-Wallis test showed a statistically significant difference in OOP share over household income between OPMD, early-and late-stage cancer, χ 2 (2)=51.05, p<0.001, with the mean percentage of 9%, 22%, and 65% respectively. This study found that the prevalence of CHE in the first year of diagnosis was 86.5% for oral cancer and 19.2% for OPMD. Indian ethnicity (OR=6.24, p=0.046) and monthly income group 'less than USD 2,722' (OR=14.32, p=0.023) were shown as significant predictors for CHE. Conclusions: Our study demonstrated the provision of subsidies may not be adequate to shield the more vulnerable group from CHE when they are diagnosed with OPMD and oral cancer.

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Provider cost of treating oral potentially malignant disorders and oral cancer in Malaysian public hospitals

Cited by 5 publications

References 28 publications

Outpatient Dental Treatment Expenditure for Patients with Oromaxillofacial Cancer: A Cohort Study in Taiwan

Outpatient Dental Treatment Expenditure for Patients with Oromaxillofacial Cancer: A Cohort Study in Taiwan

Financial burden of heart failure in Malaysia: A perspective from the public healthcare system

Household Catastrophic Health Expenditure from Oral Potentially Malignant Disorders and Oral Cancer in Public Healthcare of Malaysia

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